胃镜下核仁组成区嗜银蛋白定量检测在可疑恶性溃疡患者随访中的指导意义探讨  

Contrast study between quantitative detection of AgNOR and follow-up mucosal pathological changes in 58 patients with suspected malignant gastric ulcer during gastroscopy

作　　者：林一帆[1] 雷春红[1] 宋福林[2] 邹蕾[1] 李昊燃[1] 陆宇平[1] 高文艳[1] 巩阳[1] 刘杨[1] 陈山泉[1] 王长洪[1] 

机构地区：[1]沈阳军区总医院中医科(国家中西医结合消化病重点专科),辽宁沈阳110015 [2]沈阳军区总医院病理科,辽宁沈阳110015

出　　处：《中国内镜杂志》2009年第11期1126-1128,共3页China Journal of Endoscopy

基　　金：辽宁省自然科学基金项目(No:20052070)

摘　　要：目的探讨核仁组成区嗜银蛋白(AgNOR)检测对良恶性溃疡的鉴别及可疑恶变溃疡的临床随访、2次活检的辅助指导价值。方法对58例经首次胃镜检查可疑恶性溃疡、活检病理未能确诊为胃癌的患者进行AgNOR银染法染色,并行图像分析检测后密切临床随访,随访时间1～72周(平均7周),所有患者均再次胃镜复查,组织活检,病理检查。结果AgNOR每核平均颗粒数>7.0的30例患者中有19例二次活检病理检查确诊为胃癌(63.3%),AgNOR每核平均颗粒数<7.0的28例患者中有5例确诊为胃癌(17.9%),两组胃癌捡出率差异有显著性(P<0.01)。结论AgNOR颗粒数量增多可能与胃癌关系密切,对AgNOR每核平均颗粒数>7.0的患者进行密切随访,有助于胃癌的早期发现。[ Objective ] To study the value of quantitative detection of silver--staining nueleolar organizer region （AgNOR） in diagnosis and instructing follow-up mucosal pathological determination in the patients with suspected malignant gastric ulcer under gastroscope. [Methods] The quantitative detection of AgNOR of 58 patients who were suspected as malignant gastric ulcer during gastroseopy was studied by using image analysis. The re-examination of gas- troseopy and the mueosal pathological determination were performed after follow-up for 1 to 72 months. [Results] Nineteen out of thirty cases whose quantity of AgNOR per nucleus was more than 7.0 （63.3%） were finally diagnosed as gastric carcinoma ; only five out of twenty night cases whose quantity of AgNOR per nucleus was less than 7.0 （17.9%） were finally diagnosed as gastric carcinoma （P〈0.01）. [Conclusion] The increasing quantity of AgNOR may be of some value in the potential for subsequent gastric carcinoma in the patients with suspected malignant gastric ulcer under gastroscope. It is helpful for earlier detection of gastric carcinoma if close follow-up is performed in those patients.

关 键 词：胃溃疡 胃癌 诊断 AGNOR 

分 类 号：R735.2[医药卫生—肿瘤]